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Catheter-delivered ultrasound potentiates in vitro thrombolysis
R D Shlansky-Goldberg1, D B Cines, C M Sehgal
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Purpose:
To develop a catheter-directed method to enhance urokinase- mediated thrombolysis with use of ultrasound.
Materials And Methods:
A prototype catheter was constructed by using a 9-F piezoelectric crystal capable of producing 640-kHz pulsed ultrasound energy. Clots formed in vitro from whole blood were trace-labeled with iodine-125 fibrinogen, and the release of radiolabeled fibrin degradation products was measured in the presence of urokinase, ultrasound, or a combination of urokinase and ultrasound.
Results:
By 30 minutes, clot lysis was more complete with urokinase plus ultrasound (78.7% +/- 5.3 [mean +/- SD]) than with ultrasound alone (19.3% +/- 10.0) or urokinase alone (47.9% +/- 10.0) (P < .001 for ultrasound and urokinase vs either alone). The time to 50% clot lysis was shortened by 46% on average with the application of urokinase and ultrasound compared with urokinase alone (P < .03).
Conclusions:
Catheter-based ultrasound enhances enzymatic thrombolysis in vitro and may be a practical means to reduce the dose of enzyme and the time needed to achieve clot lysis in vivo.